Ducks-In-A-Row

Reducing Home Health Visits?

Utilizing Your Home Health Software for Success.

We’ve had some pretty serious payment cuts over the last couple of years and most of the home health leaders I visit with expect more.  I agree.
So, how do you deal with this?  Simple…reduce visits.  Before you pick up the phone to advise me of my errant directions, or before you start reducing visits, please read further.

We know that the average number of visits per home health episode is coming down.  I believe this is necessary, but if you are reducing visits, you better make sure all of your ducks are in row.  It must be done in a way to maintain acceptable patient outcomes, and you better make sure your clinical documentation is thorough.

I won’t spend a lot of time telling you the obvious about documenting thoroughly.  You already know by now that your agency is at risk from vigilant RACs and ZPICs if you aren’t documenting thoroughly. You should also know that if your visits per episode are lower than national and state averages, you may be more likely to get their attention.  However, I will point out a few things you should have in place before you start reducing visits:

  1. A system to monitor key business metrics; compared to other agencies, for patient outcomes, documentation review, eligibility and making sure you are getting paid the correct amounts (manual is better than nothing, but Business Intelligence from HEALTHCAREfirst is the best)
  2. Training, visibility and accountability for your clinical staff and their documentation (partner consultants, tools in firstHOMECARE and Business Intelligence from HEALTHCAREfirst can help with some of this)
  3. Routine monitoring of your patient outcomes (waiting for Home Health Compare to be updated on the CMS website isn’t enough) with visibility into which documents and which nurses need attention (you have reports and warnings in firstHOMECARE to help with this).
  4. A way to engage patients when you’re not there.  This will be critical in being able to reduce visits, as you shift from a “planned” visit model to an “appropriate” visit model.  Very effective and inexpensive systems are available to automatically call your patients and alert you when a patient needs to be checked on and possibly made a physical visit – our partner Continuity Health Solutions offers a $29 per month, per patient system (reduce one visit per month and you are more than paying for this system).

These are just a few things to think about.  Many agencies today are effectively accomplishing reduced visits and regaining lost margins, while improving patient outcomes.

September 28, 2012

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